FRONTAL LOBOTOMY : Clinical Experience with 107 Cases in a State Hospital

Since May, 1946, 107 patients have undergone frontal lobotomy at the Fairfield State Hospital. The group was composed almost entirely of individuals suffering from chronic mental illness whose prognosis seemed extremely unfavorable; 85% were schizophrenics. The average duration of mental illness was 7.4 years and of hospitalization, 4.4 years prior to operation. The results following lobotomy have been encouraging: 56.7% of the entire group exhibited significant improvement; thus far, 37.4% have been able to leave the hospital. The mortality rate was low and complications, except for convulsive seizures, have been relatively infrequent. Prognostic guides seem to consist chiefly of the type of illness and the character of symptomatology. Results were best in the nonschizophrenic group, next best in the paranoid, catatonic, and mixed types of schizophrenia, and poorest in simple and hebephrenic dementia præcox. Disturbed, aggressive, combative, and hostile patients appeared to receive maximum benefit. Duration of illness had relatively little significance as a prognostic guide. Lobotomy may be especially helpful in patients suffering from pulmonary tuberculosis, which is a specific contraindication to shock therapy. There is no reduction of intellectual functioning following operation; our patients who could be tested exhibited an average rise of 10 points on the Wechsler-Bellevue scale 6 months postoperatively. Lobotomy appears to be a fruitful method in the treatment of chronic mental disease.